Abuse of Older Women

There has been slow but increasing awareness of elderly abuse over the past 20 years. As challenging as it is for the population at large to acknowledge, it is even harder for older people to admit that they have been victimized. As a result, statistical evidence on the extent of elderly abuse is scarce.

A 2002 World Health Organization (WHO) study on the abuse of older adults in Germany, France, Sweden, Thailand, Kenya and Columbia reinforced “how difficult elder abuse is for some older adults to discuss.” Even when research participants do acknowledge sexual abuse, they tend to deny its extent or impact. Older people are often reluctant to reveal incidents of sexual violence because discussion of any sexual activity is often deemed inappropriate, “rendering the disclosure of abusive situations even more taboo and inconceivable.”

The global proportion of people aged 60 years and older is projected to double between 2000 and 2050 from 10 percent to 21 percent. Because women make up the majority of older adults in almost all countries around the world – and because the proportion of women to men increases with age – it is important to understand the forms of violence against older women and the cultural traditions that place them in peril.

Older women are more vulnerable to abuse than older men and are burdened with a lifetime of experiences and beliefs that may increase their susceptibility. What holds true in youth remains so in age: In most instances, “Those who are victims are female; those who abuse are male.” Violence and abuse against older women can be sexual, physical or psychological and also can include material or financial abuse and neglect. It can occur in the home, in institutions or as a result of harmful cultural practices that specifically target older women.

Abuse in the home

Researchers have identified domestic violence as the most common form of abuse against elderly females, and many women who suffer at the hands of their partners when they are young continue to be abused in their old age. In a South Korean study 21.5 percent of elderly married couples admitted to experiencing intimate-partner violence. The research showed that older men with a history of domestic violence abused their wives throughout their relationships. In some cases, the abuse did not begin until later in the marriage, when a husband’s frustrations with domestic changes that accompany older age, such as retirement, caused him to act out physically against his wife. In a 2003 study in the United States, 38 older women between 55 years and 90 years of age discussed their experiences with domestic violence. Many of the women admitted that they had stayed in violent relationships because societal expectations at the time of their marriage required them to “submit to the physical and sexual wishes of their husbands.”

Older women without intimate partners may be particularly vulnerable to abuse by other family members. Sons, for example have been implicated as perpetrators of sexual violence against their mothers. In research in the Cape Flats township in South Africa, “Older people identified sexual abuse as the most common form of violence, including adult sons forcing their mothers to have sex with them.” One older woman explained the indignity of such abuse:

“When you are a mother…left behind with children who are boys, there is one amongst your children … he wants to sleep with you and wants that you must not talk about it … You are afraid because you do not have the strength. He does that thing as he pleases.”

In a British study, more than half of the older women who had been sexually assaulted were abused by their adult sons, and most of the abuse was vaginal rape. One theory suggests that adult sons who sexually assault their elderly mothers are assuming the roles of their abusive fathers. Another reason for this kind of abuse is the misconception in some communities that sex with older people can cur HIV/AIDS, a counterpart to the myth of the “virgin cure”.

Although studies have shown that sexual abuse at home usually is perpetrated by a relative, it also can be inflicted by unrelated domestic caregivers or by random assailants. While many people think that rape is a “sexually motivated crime” that affects only younger women, it is also, in fact, perpetrated against older women, whose perceived or actual vulnerability makes them likely victims. In one case in the United States, a 19-year-old male broke into the apartment of a 76-year-old women, “ripped off her clothing, raped her vaginally, then anally, and finally assaulted her vaginally with an umbrella lying nearby. He used a piece of glass from the broken window to cut her throat.” In another case, a 20-year-old offender assaulted and murdered a 77-year-old woman. He “repeatedly stabbed her in the face, chest, and vagina with a butcher knife.”

In Eastern Europe and Russia, older women are becoming more frequent targets for criminal attacks. In the Caribbean, where many older women have been sexually abused, one woman expressed her concern about being raped by youth gangs: “I am afraid to go out alone, even on the beach or for a little walk.” Latin America has been identified as a region with particular social conditions that exacerbate violence against the elderly, including civil war, crime and drug-related violence. In Zimbabwe, 30 percent of the respondents to a study on violence against the elderly said that the threat of being attacked was severe enough to prevent them from participating in their own communities.

Abuse in institutional settings

While institutions such as adult-care facilities and hospitals can provide elderly people with support and security, residents are still at risk of sexual abuse by staff, other residents and visitors. One study of sexual crimes against the elderly in the state of Virginia in the United States revealed that 71 percent of assaults against older people took place in nursing homes. Many incidents are difficult to investigate, however, because the age and health of the victim and/or perpetrator may compromise his or her ability to recollect important details of the assault.

There are no national or cross-national studies that focus specifically on sexual abuse in institutions, but the cases that are reported illustrate the types of crimes that are being perpetrated. For example, an 84-year-old male resident of a nursing home in the United States committed numerous abuses: “One aide saw him rubbing an elderly woman through her adult diaper, another caught him on top of a resident, her pajamas pushed up around her neck. He was found in one woman’s room as she cowered behind a chair, naked.” In another case, also in the United States, police found an elderly woman who had run away from her nursing home wandering near a major highway. She did not want to return: “I want to die. Please hit me with your car,” she begged. Several weeks later a nursing assistant walked into the woman’s room and found a frequent male visitor with his hands between the woman’s legs.”

While the number of older adults living in care facilities is low – between 4 percent and 7 percent in developed countries, between 1 percent and 4 percent in Latin America and even lower in other developing regions – lack of regulation or enforcement of rules at hospitals and nursing homes can create environments that are unsafe for older females. In developing countries, elderly patients are frequently mistreated in institutions, many of which lack the necessary structural capacity and personnel. In Kenya, for example, the head of one hospital admitted, “Older people are a big headache and a waste of scarce resources. The biggest favour you could do to me as an older people’s organization is to get them out of my hospital.”